Charting the Leadership Course: Tales From the High Seas

What qualities make a radiology leader? What experiences best prepare leaders to assume their roles? How do leaders know whether they are performing to the best of their abilities?
These were among the questions that Radiology Business Journal recently asked four undisputed industry leaders: a radiology-department chair, a practice president, a practice CEO, and a hospital radiology executive. All four shared a wealth of perspectives and philosophies, using anecdotes and other
glimpses into the workings of their organizations to illustrate their points.

The Radiology Chair: Putting Creativity to the Test

Four years ago, Steven Seltzer, MD, FACS, and his colleagues determined that the department of radiology at Brigham and Women’s Hospital in Boston, Massachusetts, needed a cyclotron to support molecular-imaging research and other endeavors. Seltzer knew that the acquisition would present obstacles, from budgetary and logistics standpoints, but he was determined to succeed in his endeavor—and he didn’t mind spending time coming up with a solution.

The solution: A consortium of Brigham and Women’s Hospital, Harvard Medical School, the Dana-Farber Cancer Institute (Boston), and faculty and corporate sponsors was formed to finance what Seltzer calls the 50-ton monster, while a crane was used to hoist it above nearby buildings and to its destination.

Seltzer has served, since 1997, as chair of the Brigham and Women’s Hospital radiology department and as the Philip H. Cook professor, department of radiology, at Harvard Medical School. He says, “Dealing with seemingly ubiquitous people problems is my least favorite part of being a radiology leader, but applying creativity and thinking out of the box to handle bigger challenges (such as this one) are what I like best. They keep me on my toes.”

RBJ: As the leader of a large and prestigious academic department, you have responsibilities for teaching, research, and patient care. How do you balance their varying leadership needs?Seltzer: I position myself as a convener who sets the overall strategic direction of the department. Beneath this layer is a very capable, very effective management team, and each of its members concentrates on one aspect of our mission, be it clinical/medical, educational, or financial.

RBJ: What have you done to ensure that after you move on, the organization will continue to thrive?Seltzer: I keep it an open topic of discussion among members of the department and the leadership of the health-care system. I believe in being as transparent as possible in identifying the specific individuals who should be groomed for positions of leadership.
Some hospitals and academic institutions are sheepish about the fact that they have CEOs because they think it smacks of the corporate realm. The management of a $2 billion organization, however, has to take on the characteristics of the management of a corporation, when it comes to carrying out the mission and handling succession.

RBJ: How do you assess the job that you are doing as a leader?Seltzer: We have reasonably robust IT tools to track performance through performance metrics. I review this information with hospital leaders and others at least once a year—and often, more frequently than that.

I also conduct informal 360° evaluations of myself as part of my annual performance review, inviting comments and feedback from subordinates and supervisors. We look at subjective issues, such as whether the physicians and technicians believe I am going in the right direction with the department and all of its initiatives, as well as quantitative issues—for example, the number of research grants procured.

RBJ: What are the most important reports that you need (weekly, monthly, and annually) to do your job?Seltzer: The most important weekly report—really, the most important daily report—isn’t an in-house one, but rather, news of what is happening on Boston’s Beacon Hill and on Capitol Hill. This is because so much short-term direction is shaped by politics and what is going to happen, or probably going to happen, with health-care reform.

Monthly, it is very detailed reports of procedure volumes, performance efficiencies, and our financial status. On a yearly cycle, the most critical reports have to do with research and teaching—the number of federal individual grants we have received to support research, the number of peer-reviewed publications in which work has appeared, and teaching accomplishments.